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Get Wsib Form 6 Printable 2005-2024

Flr-6. qxd 1/25/02 11 00 AM Page 1 ONTARIO Court File Number / Num ro de dossier du greffe Name of Court/Nom du tribunal at situ e au Court office address / Adresse du greffe Form 6 Acknowledgement of Service Formule 6 Accus de r ception de la signification You are asked to fill out and sign this card and to mail it immediately. If you do not return this card the document s listed below may be personally served on you and you may be ordered to pay the costs of service. Veuillez remplir et signer la pr sente carte et la mettre la poste imm diatement. Si vous ne la retournez pas le ou les documents num r s cidessous peuvent vous tre signifi s personne et il peut vous tre ordonn de payer les frais de la signification* My name is full legal name / Je m appelle nom et pr nom officiels. I may be served at address where court documents may be mailed to you Les documents peuvent m tre signifi s au adresse o les documents de proc dure peuvent vous tre envoy s. I acknowledge receiving a copy of the following document s / J accuse r ception d une copie du ou des documents suivants Application dated / Demande dat e du. Notice of motion dated / Avis de motion dat du Blank form of application / Exemplaire de la formule de demande Statement of money owed dated / tat des sommes dues dat du Financial statement dated / tat financier dat du. Blank form of financial statement / Exemplaire de la formule d tat financier Other. Give title and date of document. / Autre. Donnez le titre et la date du document. Answer dated / D fense dat e du. Blank form of answer / Exemplaire de la formule de d fense. Affidavit of name / Affidavit de nom. dated / dat du. Signature Date of signature / Date de la signature NOTICE The address that you give above will be used in future to serve documents by mail until you inform the other parties and the court office of a new address for service. REMARQUE L adresse que vous indiquez ci-dessus servira l avenir vous signifier des documents par la poste jusqu ce que vous avisiez les autres parties et le greffe d une nouvelle adresse aux fins de signification* FLR 6 September 1 2005 / 1er septembre 2005 From/De STAMP To/ TIMBRE. If you do not return this card the document s listed below may be personally served on you and you may be ordered to pay the costs of service. Veuillez remplir et signer la pr sente carte et la mettre la poste imm diatement. Si vous ne la retournez pas le ou les documents num r s cidessous peuvent vous tre signifi s personne et il peut vous tre ordonn de payer les frais de la signification* My name is full legal name / Je m appelle nom et pr nom officiels. Veuillez remplir et signer la pr sente carte et la mettre la poste imm diatement. Si vous ne la retournez pas le ou les documents num r s cidessous peuvent vous tre signifi s personne et il peut vous tre ordonn de payer les frais de la signification* My name is full legal name / Je m appelle nom et pr nom officiels. I may be served at address where court documents may be mailed to you Les documents peuvent m tre signifi s au adresse o les documents de proc dure peuvent vous tre envoy s.

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